The diagnosis of leprosy is delayed in the United Kingdom

Diagnostic delay in leprosy can have serious neurological consequences for the patient. We studied the presentation of leprosy patients, focusing on d elays in diagnosis, in a retrospective case-note review of 28 patients refe rred to The Hospital for Tropical Diseases during 1995-1998. The median age s at onset of symptoms and at diagnosis were 25.1 years (range 9-77.7) and 30.1 years (range 9-78.3), respectively. The median time from symptom onset to diagnosis was 1.8 years (0.2-15.2). Prior to referral to a leprologist, patients had seen a dermatologist (20), neurologist (9), orthopaedic surge on (5) and rheumatologist (2). Delay in diagnosis occurred in 82% of cases. Misdiagnoses as dermatological and neurological conditions were important causes of delay, and 68% of patients had nerve damage resulting in disabili ty. Leprosy can be difficult to diagnose outside endemic areas. Increased a wareness amongst general practitioners and hospital specialists would lead to more rapid diagnosis, thus minimizing damage and disability.